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We thus aimed to assess the prevalence, determinants and quantity of BHR in Helsinki. Objectives: This study involved 292 randomly selected subjects age 26-66 years, women comprising 58%. Methods: Following a structured interview, a spirometry, a bronchodilation test, and a skin-prick test, we assessed a bronchial challenge test with inhaled histamine using a dosimetric tidal breathing method. Results included the provocative dose inducing a decrease in FEV1 by 15% (PD15FEV1) and the dose-response slope. For statistical risk factor-analyses, the severity of BHR was considered; PD15 values ≤1.6 mg (BHR) and ≤0.4 mg [moderate or severe BHR (BHRms)] served as cut-off levels. Results: BHR presented in 21.2% and BHRms in 6.2% of the subjects. FEV1 < 80% of predicted [odds ratio (OR) 4.09], airway obstruction (FEV1/forced vital capacity < 88% of predicted) (OR 4.33) and history of respiratory infection at age <5 (OR 2.65) yielded an increased risk for BHR as ORs in multivariate analysis. For BHRms, the determinants were decreased FEV1 below 80% of predicted (OR 27.18) and airway obstruction (OR 6.16). Respiratory symptoms and asthma medication showed a significant association with BHR. Conclusions: Of the adult population of Helsinki, 21% showed BHR to inhaled histamine. The main determinants were decreased FEV1 and airway obstruction. Quantitative assessment of BHR by different cut-off levels provides a tool for characterization of phenotypes of airway disorders in epidemiologic and clinical studies. Please cite this paper as: Juusela M, Pallasaho P, Sarna S, Piirilä P, Lundbäck B and Sovijärvi A. Bronchial hyperresponsiveness in an adult population in Helsinki: decreased FEV1, the main determinant. Clin Respir J 2013; 7: 34-44.", "publicationTitle": "Clinical Respiratory Journal", "publisher": "", "place": "", "date": "January 2013", "volume": "7", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "34-44", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Clinical Respiratory Journal", "DOI": "10.1111/j.1752-699X.2012.00279.x", "citationKey": "", "url": "http://libpublic3.library.isu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=86380021&site=eds-live", "accessDate": "2015-11-13T16:26:35Z", "PMID": "", "PMCID": "", "ISSN": "17526981", "archive": "", "archiveLocation": "", "shortTitle": "Bronchial hyperresponsiveness in an adult population in Helsinki", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "ASTHMA -- Treatment", "type": 1 }, { "tag": "BRONCHIAL spasm", "type": 1 }, { "tag": "HISTAMINE", "type": 1 }, { "tag": "RESPIRATORY obstructions", "type": 1 }, { "tag": "SPIROMETRY", "type": 1 }, { "tag": "bronchial hyperresponsiveness", "type": 1 }, { "tag": "respiratory symptoms", "type": 1 }, { "tag": "sensitization", "type": 1 } ], "collections": [], "relations": { "owl:sameAs": "http://zotero.org/groups/416403/items/E53CB8GS" }, "dateAdded": "2015-11-13T16:29:22Z", "dateModified": "2015-11-13T16:29:22Z" } }, { "key": "IVA87ZZ8", "version": 7, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/IVA87ZZ8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/IVA87ZZ8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2642323, "username": "bodaseth", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bodaseth", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "IVA87ZZ8", "version": 7, "itemType": "webpage", "title": "What is Asthma? | Causes, Symptoms & Treatment | ACAAI", "creators": [], "abstractNote": "", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://acaai.org/asthma", "accessDate": "2015-11-09T03:17:43Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2015-11-09T03:17:43Z", "dateModified": "2015-11-09T03:17:43Z" } }, { "key": "RC4F3IWZ", "version": 6, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/RC4F3IWZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/RC4F3IWZ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/427258/items/ERMSUVGK", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } } }, "data": { "key": "RC4F3IWZ", "version": 6, "parentItem": "ERMSUVGK", "itemType": "attachment", "linkMode": "linked_url", "title": "Full Text PDF", "accessDate": "2015-11-07T21:57:47Z", "url": "http://journal.publications.chestnet.org/data/Journals/CHEST/934106/chest_147_6_1582.pdf", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-11-07T21:57:47Z", "dateModified": "2015-11-07T21:57:47Z" } }, { "key": "ERMSUVGK", "version": 6, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/ERMSUVGK", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/ERMSUVGK", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } }, "creatorSummary": "Pakhale et al.", "parsedDate": "2015-06-01", "numChildren": 1 }, "data": { "key": "ERMSUVGK", "version": 6, "itemType": "journalArticle", "title": "Effects of weight loss on airway responsiveness in obese adults with asthma: Does weight loss lead to reversibility of asthma?", "creators": [ { "creatorType": "author", "firstName": "Smita", "lastName": "Pakhale" }, { "creatorType": "author", "firstName": "Justine", "lastName": "Baron" }, { "creatorType": "author", "firstName": "Robert", "lastName": "Dent" }, { "creatorType": "author", "firstName": "Katherine", "lastName": "Vandemheen" }, { "creatorType": "author", "firstName": "Shawn D.", "lastName": "Aaron" } ], "abstractNote": "BACKGROUND: \nThe growing epidemics of obesity and asthma are major public health concerns. Although asthma-obesity links are widely studied, the effects of weight loss on asthma severity measured by airway hyperresponsiveness (AHR) have received limited attention. The main study objective was to examine whether weight reduction reduces asthma severity in obese adults with asthma.METHODS:\nIn a prospective, controlled, parallel-group study, we followed 22 obese participants with asthma aged 18 to 75 years with a BMI ≥ 32.5 kg/m2 and AHR (provocative concentration of methacholine causing a 20% fall in FEV1 [PC20] < 16 mg/mL). Sixteen participants followed a behavioral weight reduction program for 3 months, and six served as control subjects. The primary outcome was change in AHR over 3 months. Changes in lung function, asthma control, and quality of life were secondary outcomes.RESULTS:\nAt study entry, participant mean ± SD age was 44 ± 9 years, 95% were women, and mean BMI was 45.7 ± 9.2 kg/m2. After 3 months, mean weight loss was 16.5 ± 9.9 kg in the intervention group, and the control group had a mean weight gain of 0.6 ± 2.6 kg. There were significant improvements in PC20 (P = .009), FEV1 (P = .009), FVC (P = .010), asthma control (P < .001), and asthma quality of life (P = .003) in the intervention group, but these parameters remained unchanged in the control group. Physical activity levels also increased significantly in the intervention group but not in the control group.CONCLUSIONS:\nWeight loss in obese adults with asthma can improve asthma severity, AHR, asthma control, lung function, and quality of life. These findings support the need to actively pursue healthy weight-loss measures in this population.", "publicationTitle": "Chest", "publisher": "", "place": "", "date": "June 1, 2015", "volume": "147", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "1582-1590", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Chest", "DOI": "10.1378/chest.14-3105", "citationKey": "", "url": "http://dx.doi.org/10.1378/chest.14-3105", "accessDate": "2015-11-07T21:57:47Z", "PMID": "", "PMCID": "", "ISSN": "0012-3692", "archive": "", "archiveLocation": "", "shortTitle": "Effects of weight loss on airway responsiveness in obese adults with asthma", "language": "", "libraryCatalog": "Silverchair", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2015-11-07T21:57:47Z", "dateModified": "2015-11-07T21:57:47Z" } }, { "key": "3ZNKUJKQ", "version": 5, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/3ZNKUJKQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/3ZNKUJKQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } }, "parsedDate": "2015-05", "numChildren": 1 }, "data": { "key": "3ZNKUJKQ", "version": 5, "itemType": "journalArticle", "title": "Comparison of the effectiveness and safety of formoterol versus salmeterol in the treatment of patients with asthma: A systematic review and meta-analysis", "creators": [], "abstractNote": "Background: Formoterol and salmeterol are two long-acting β2-agonists given by inhalation, with bronchodilating effects lasting for at least 12 h after a single administration. Formoterol has a faster onset of action compared with salmeterol. The aim of this study was to perform a systematic review and meta-analysis on the data published from previous review in order to calculate pooled estimates of effectiveness and safety assessment of formoterol and salmeterol in treatment of patients with asthma. Materials and Methods: In this study, we conducted an electronic search for medical citation databases including Cochrane, PubMed, Scopus, PsycInfo, and IranMedex. Besides manual search of the databases that record randomized clinical trials, conference proceedings, and journals related to asthma were included. Studies were evaluated by two independent people based on inclusion and exclusion criteria, and the common outcomes of studies were entered into the RevMan 5.0.1 software, after evaluation of studies and extraction of data from them; and in cases where there were homogeneous studies, meta-analysis was performed, and for heterogeneous studies, the results were reported qualitatively. Results: Of the 1539 studies initially found, 13 were included in the study. According to the meta-analysis conducted, no significant difference was found between the inhalation of formoterol 12 μg and salmeterol 50 μg in the two outcomes of mean forced expiratory volume 1 s (FEV1), 12 h after inhalation of medication and Borg score (A frequently used scale for quantifying breathlessness) after inhalation of medication. In addition, salmeterol was more effective than formoterol in the two outcomes of percent decrease in FEV1 after inhalation of methacholine and the number of days without an attack. Since the two outcomes of FEV1 30-60 min after inhalation of medication and morning peak expiratory flow after inhalation of medication were heterogeneous, they had no meta-analysis capabilities, and its results were reported qualitatively. Conclusion: The data from included studies shows that, more efficacy has been achieved with Salmeterol, especially in some outcomes such as the percent decrease in FEV1 after inhalation of Methacholine, and the number of days without an attack; and therefore, the administration of Salmeterol seems to be beneficial for patients, compared with Formoterol.", "publicationTitle": "Journal of Research in Medical Sciences", "publisher": "", "place": "", "date": "May 2015", "volume": "20", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "483-490 8p", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Journal of Research in Medical Sciences", "DOI": "", "citationKey": "", "url": "http://libpublic3.library.isu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109281285&site=ehost-live", "accessDate": "2015-11-07T21:56:18Z", "PMID": "", "PMCID": "", "ISSN": "1735-1995", "archive": "", "archiveLocation": "", "shortTitle": "Comparison of the effectiveness and safety of formoterol versus salmeterol in the treatment of patients with asthma", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Asthma", "type": 1 }, { "tag": "Asthma -- Drug Therapy -- Iran", "type": 1 }, { "tag": "Bronchodilator Agents", "type": 1 }, { "tag": "Bronchodilator Agents -- Administration and Dosage", "type": 1 }, { "tag": "Bronchodilator Agents -- Pharmacodynamics", "type": 1 }, { "tag": "Chi Square Test", "type": 1 }, { "tag": "Cochrane Library", "type": 1 }, { "tag": "Confidence Intervals", "type": 1 }, { "tag": "Data Analysis Software", "type": 1 }, { "tag": "Forced Expiratory Volume", "type": 1 }, { "tag": "Human", "type": 1 }, { "tag": "Iran", "type": 1 }, { "tag": "Meta Analysis", "type": 1 }, { "tag": "P-Value", "type": 1 }, { "tag": "Psycinfo", "type": 1 }, { "tag": "PubMed", "type": 1 }, { "tag": "Salmeterol", "type": 1 }, { "tag": "Salmeterol -- Administration and Dosage", "type": 1 }, { "tag": "Salmeterol -- Pharmacodynamics", "type": 1 }, { "tag": "Systematic Review", "type": 1 }, { "tag": "Treatment Outcomes", "type": 1 }, { "tag": "formoterol", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2015-11-07T21:56:18Z", "dateModified": "2015-11-07T21:56:18Z" } }, { "key": "BNUMSHJU", "version": 5, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/BNUMSHJU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/BNUMSHJU", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/427258/items/3ZNKUJKQ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } } }, "data": { "key": "BNUMSHJU", "version": 5, "parentItem": "3ZNKUJKQ", "itemType": "attachment", "linkMode": "linked_url", "title": "EBSCO Full Text", "accessDate": "2015-11-07T21:56:18Z", "url": "http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=109281285&S=R&D=a9h&EbscoContent=dGJyMNHX8kSeprU4zOX0OLCmr02ep7RSs6y4Sa%2BWxWXS&ContentCustomer=dGJyMPGsski0prFJuePfgeyx44Dt6fIA", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-11-07T21:56:18Z", "dateModified": "2015-11-07T21:56:18Z" } }, { "key": "G56MZJDZ", "version": 4, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/G56MZJDZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/G56MZJDZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "G56MZJDZ", "version": 4, "itemType": "webpage", "title": "Emerging therapeutic options for the treatment of patients with symptomatic asthma - 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Interventions have been developed to overcome difficulties in asthma management. These include chronic disease management programmes, which are more than simple patient education, encompassing a set of coherent interventions that centre on the patients' needs, encouraging the co-ordination and integration of health services provided by a variety of healthcare professionals, and emphasising patient self-management as well as patient education.\n\nObjectives\nObjectives\n\nTo evaluate the effectiveness of chronic disease management programmes for adults with asthma.\n\nSearch methods\nSearch methods\n\nCochrane Central Register of Controlled Trials (CENTRAL), Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, MEDLINE (MEDLINE In-Process and Other Non-Indexed Citations), EMBASE, CINAHL, and PsycINFO were searched up to June 2014. We also handsearched selected journals from 2000 to 2012 and scanned reference lists of relevant reviews.\n\nSelection criteria\nSelection criteria\n\nWe included individual or cluster-randomised controlled trials, non-randomised controlled trials, and controlled before-after studies comparing chronic disease management programmes with usual care in adults over 16 years of age with a diagnosis of asthma. The chronic disease management programmes had to satisfy at least the following five criteria: an organisational component targeting patients; an organisational component targeting healthcare professionals or the healthcare system, or both; patient education or self-management support, or both; active involvement of two or more healthcare professionals in patient care; a minimum duration of three months.\n\nData collection and analysis\nData collection and analysis\n\nAfter an initial screen of the titles, two review authors working independently assessed the studies for eligibility and study quality; they also extracted the data. We contacted authors to obtain missing information and additional data, where necessary. We pooled results using the random-effects model and reported the pooled mean or standardised mean differences (SMDs).\n\nMain results\nMain results\n\nA total of 20 studies including 81,746 patients (median 129.5) were included in this review, with a follow-up ranging from 3 to more than 12 months. Patients' mean age was 42.5 years, 60% were female, and their asthma was mostly rated as moderate to severe. Overall the studies were of moderate to low methodological quality, because of limitations in their design and the wide confidence intervals for certain results.\nCompared with usual care, chronic disease management programmes resulted in improvements in asthma-specific quality of life (SMD 0.22, 95% confidence interval (CI) 0.08 to 0.37), asthma severity scores (SMD 0.18, 95% CI 0.05 to 0.30), and lung function tests (SMD 0.19, 95% CI 0.09 to 0.30). The data for improvement in self-efficacy scores were inconclusive (SMD 0.51, 95% CI -0.08 to 1.11). Results on hospitalisations and emergency department or unscheduled visits could not be combined in a meta-analysis because the data were too heterogeneous; results from the individual studies were inconclusive overall. Only a few studies reported results on asthma exacerbations, days off work or school, use of an action plan, and patient satisfaction. Meta-analyses could not be performed for these outcomes.\n\nAuthors' conclusions\nAuthors' conclusions\n\nThere is moderate to low quality evidence that chronic disease management programmes for adults with asthma can improve asthma-specific quality of life, asthma severity, and lung function tests. Overall, these results provide encouraging evidence of the potential effectiveness of these programmes in adults with asthma when compared with usual care. However, the optimal composition of asthma chronic disease management programmes and their added value, compared with education or self-management alone that is usually offered to patients with asthma, need further investigation.", "bookTitle": "Cochrane Database of Systematic Reviews", "series": "", "seriesNumber": "", "volume": "", "numberOfVolumes": "", "edition": "", "date": "2015/05/27", "publisher": "John Wiley & Sons, Ltd", "place": "", "originalDate": "", "originalPublisher": "", "originalPlace": "", "format": "", "pages": "", "ISBN": "", "DOI": "", "citationKey": "", "url": "http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007988.pub2/abstract", "accessDate": "2015-11-07T21:48:37Z", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "en", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2015-11-07T21:48:37Z", "dateModified": "2015-11-07T21:48:37Z" } }, { "key": "EFAU6KN6", "version": 2, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/EFAU6KN6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/EFAU6KN6", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/427258/items/IPIHPQ6W", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } } }, "data": { "key": "EFAU6KN6", "version": 2, "parentItem": "IPIHPQ6W", "itemType": "attachment", "linkMode": "linked_url", "title": "Full Text PDF", "accessDate": "2015-11-07T21:46:08Z", "url": "http://onlinelibrary.wiley.com/store/10.1002/14651858.CD001277.pub3/asset/CD001277.pdf?v=1&t=igpmes0v&s=53012c28fb94fc11315c65fdc81f7ca0655fdbb3", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-11-07T21:46:08Z", "dateModified": "2015-11-07T21:46:08Z" } }, { "key": "K7C9ZRGR", "version": 2, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/K7C9ZRGR", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/K7C9ZRGR", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/427258/items/IPIHPQ6W", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } } }, "data": { "key": "K7C9ZRGR", "version": 2, "parentItem": "IPIHPQ6W", "itemType": "attachment", "linkMode": "linked_url", "title": "Snapshot", "accessDate": "2015-11-07T21:46:08Z", "url": "http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001277.pub3/abstract", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-11-07T21:46:08Z", "dateModified": "2015-11-07T21:46:08Z" } }, { "key": "IPIHPQ6W", "version": 2, "library": { "type": "group", "id": 427258, "name": "Physiology Lab Asthma", "links": { "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/427258/items/IPIHPQ6W", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/physiology_lab_asthma/items/IPIHPQ6W", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2659416, "username": "ndavis14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/ndavis14", "type": "text/html" } } }, "creatorSummary": "Freitas et al.", "parsedDate": "2013-10-01", "numChildren": 2 }, "data": { "key": "IPIHPQ6W", "version": 2, "itemType": "bookSection", "title": "Breathing exercises for adults with asthma", "creators": [ { "creatorType": "author", "firstName": "Diana A", "lastName": "Freitas" }, { "creatorType": "author", "firstName": "Elizabeth A", "lastName": "Holloway" }, { "creatorType": "author", "firstName": "Selma S", "lastName": "Bruno" }, { "creatorType": "author", "firstName": "Gabriela SS", "lastName": "Chaves" }, { "creatorType": "author", "firstName": "Guilherme AF", "lastName": "Fregonezi" }, { "creatorType": "author", "firstName": "Karla MPP", "lastName": "Mendonça" } ], "abstractNote": "Background\nBackground\n\nBreathing exercises have been widely used worldwide as a complementary therapy to the pharmacological treatment of people with asthma.\n\nObjectives\nObjectives\n\nTo evaluate the evidence for the efficacy of breathing exercises in the management of patients with asthma.\n\nSearch methods\nSearch methods\n\nThe search for trials led review authors to review the literature available in The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and AMED and to perform handsearching of respiratory journals and meeting abstracts. Trial registers and reference lists of included articles were also consulted.\nThe literature search has been updated to January 2013.\n\nSelection criteria\nSelection criteria\n\nWe included randomised controlled trials of breathing exercises in adults with asthma compared with a control group receiving asthma education or, alternatively, with no active control group.\n\nData collection and analysis\nData collection and analysis\n\nTwo review authors independently assessed trial quality and extracted data. RevMan software was used for data analysis based on the fixed-effect model. Continuous outcomes were expressed as mean differences (MDs) with confidence intervals (CIs) of 95%. Heterogeneity was assessed by inspecting the forest plots. The Chi2 test was applied, with a P value of 0.10 indicating statistical significance. The I2 statistic was implemented, with a value greater than 50% representing a substantial level of heterogeneity.\n\nMain results\nMain results\n\nA total of 13 studies involving 906 participants are included in the review. The trials were different from one another in terms of type of breathing exercise performed, number of participants enrolled, number and duration of sessions completed, outcomes reported and statistical presentation of data. Asthma severity in participants from the included studies ranged from mild to moderate, and the samples consisted solely of outpatients. The following outcomes were measured: quality of life, asthma symptoms, number of acute exacerbations and lung function. Eleven studies compared breathing exercise with inactive control, and two with asthma education control groups. All eight studies that assessed quality of life reported an improvement in this outcome. An improvement in the number of acute exacerbations was observed by the only study that assessed this outcome. Six of seven included studies showed significant differences favouring breathing exercises for asthma symptoms. Effects on lung function were more variable, with no difference reported in five of the eleven studies that assessed this outcome, while the other six showed a significant difference for this outcome, which favoured breathing exercises. As a result of substantial heterogeneity among the studies, meta-analysis was possible only for asthma symptoms and changes in the Asthma Quality of Life Questionnaire (AQLQ). Each meta-analysis included only two studies and showed a significant difference favouring breathing exercises (MD -3.22, 95% CI -6.31 to -0.13 for asthma symptoms; MD 0.79, 95% CI 0.50 to 1.08 for change in AQLQ). Assessment of risk of bias was impaired by incomplete reporting of methodological aspects of most of the included trials.\n\nAuthors' conclusions\nAuthors' conclusions\n\nEven though individual trials reported positive effects of breathing exercises, no reliable conclusions could be drawn concerning the use of breathing exercises for asthma in clinical practice. This was a result of methodological differences among the included studies and poor reporting of methodological aspects in most of the included studies. However, trends for improvement are encouraging, and further studies including full descriptions of treatment methods and outcome measurements are required.", "bookTitle": "Cochrane Database of Systematic Reviews", "series": "", "seriesNumber": "", "volume": "", "numberOfVolumes": "", "edition": "", "date": "2013/10/01", "publisher": "John Wiley & Sons, Ltd", "place": "", "originalDate": "", "originalPublisher": "", "originalPlace": "", "format": "", "pages": "", "ISBN": "", "DOI": "", "citationKey": "", "url": "http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001277.pub3/abstract", "accessDate": "2015-11-07T21:46:08Z", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "en", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2015-11-07T21:46:08Z", "dateModified": "2015-11-07T21:46:08Z" } } ]